We invest in a broad range of research on issues important to New Zealand, and support the development of health research careers. Our mission is 'benefiting New Zealand through health research'.
News and Media
Our latest and archived media releases and news articles.
22 March 2017
Kiwi researchers have developed a new and simple process that is helping therapists accurately predict how well their patients will regain the use of their hands and arms after a stroke.
Associate Professor Cathy Stinear and her team at the University of Auckland have created and tested a unique algorithm with therapists treating stroke patients at Auckland Hospital as part of a Health Research Council of New Zealand (HRC)-funded study to better target stroke rehabilitation and improve patients’ outcomes.
The PREP algorithm (Predicting REcovery Potential) can be used in the initial days after a person has had a stroke to predict if they will have an ‘excellent’, ‘good’, ‘limited’ or ‘poor’ recovery of their hand and arm.
The findings from the study, which have been published online this month in the top international journal Stroke, showed the algorithm could correctly predict how well stroke patients’ hands and arms recovered in about 80 per cent of cases, something which is notoriously difficult to do otherwise.
“Your ability to live independently six months after a stroke depends on three main things: your age, the severity of the initial stroke, and how well your hand and arm recover movement. We can’t do anything about your age or how bad your stroke was, but we can do something about how we rehabilitate your hand and arm,” says Dr Stinear.
Research done overseas shows that therapists aren’t very good at predicting how well someone who has had a stroke will be using their hand and arm in three or six months’ time, regardless of how much clinical experience they have. Dr Stinear says there have been particular difficulties predicting recovery in the middle group – that’s people whose movement is not terrible, but not great either.
In this study, recovery predictions were provided for 110 stroke patients and withheld from 82 stroke patients in a comparison group.
Dr Stinear and her team found that therapists who used PREP were more confident that they knew what to expect for their patients’ recovery. This knowledge helped them to tailor their rehabilitation therapy to better meet each patients’ individual needs. In turn, this helped their patients to leave hospital and get back to their homes a week earlier on average than patients who didn’t receive the prediction information.
“What we’ve done is develop a simple algorithm that can make accurate predictions for individual patients, help therapists confidently tailor their therapy, and help patients leave hospital a week earlier with no negative effects on their recovery or satisfaction with care,” says Dr Stinear.
Using the PREP algorithm, the prognosis for close to two-thirds of stroke patients can be made with a simple two-minute clinical assessment of strength in a person’s upper limb. If patients score less than 5 out of 10 on this test (about a third of patients), therapists then use a safe and non-invasive method called transcranial stimulation (TMS) to test how well messages are getting from the stroke side of the brain down to the muscles of the weak hand and arm.
“We’ve had patients who can’t move their hand and arm at all, but when we use the TMS test and stimulate that movement area of their brain, we can see a response in those muscles. This tells us that even though things are looking pretty grim for that person at that point in time, they actually have great potential for recovery because the system still works,” says Dr Stinear.
“This information helps us identify patients whose potential for recovery with intense therapeutic input might otherwise go unrecognised and unrealised. It’s also really important for the patient and their family because it gives them hope and makes them more optimistic about recovery.”
For patients who don’t reach the required threshold in the TMS test, an MRI scan is used to see how much structural damage has been done to the key connections in their brain responsible for movement. This can be used to predict if there are enough residual connections to get at least some movement back to help with basic things like dressing and bathing.
One possible concern was that people with a worse outlook might not be given as much rehabilitation, however, Dr Stinear says this wasn’t the case. The predictions didn’t affect the amount of therapy that patients completed, only the goals and content of the therapy. Patients who received the prediction information recovered just as well those who didn’t.
Dr Stinear’s HRC funding also supported neurological physiotherapist and doctoral student Marie-Claire Smith to run a parallel study for patients with walking difficulties after a stroke. Ms Smith has created another algorithm that can predict when stroke patients will be able to walk independently again with more than 90 per cent accuracy and using just two simple clinical assessments.
HRC Chief Executive Professor Kath McPherson says this research will help therapists and the families of stroke patients get a much more accurate picture of both the level and duration of support that the stroke patient is going to need.
“This is a great example of translational research in action. Cathy and her team have trained therapists at Auckland Hospital to use this tool and they are currently busy helping other hospitals in New Zealand and the US and UK to use it too. They’ve also committed to making all of the resources developed freely available to download online through their wikispace site to give back to the community and maximise New Zealanders’ return on investment,” says Professor McPherson.
View the publication in Stroke: http://stroke.ahajournals.org/content/early/2017/03/09/STROKEAHA.116.015790?ijkey=dYpqSi2hJIroQz1&keytype=ref
More information on PREP is available at http://prepforstrokerehab.wikispaces.com/
22 March 2017
The research team involved in the groundbreaking Dunedin Study at the University of Otago have been awarded the prestigious Prime Minister's Science Prize (2016).
The $500,000 award was presented to Director of the Dunedin Multidisciplinary Health and Development Research Unit, Professor Richie Poulton, yesterday in Wellington by Prime Minister Bill English.
The Dunedin Study is the most detailed of its kind in the world. Hundreds of international studies with significant societal impact have come from assessments of a cohort of 1037 children born at Queen Mary Maternity Hospital in 1972-73. There are still 961 study members participating, representing 95 per cent of those still alive. Thirty-eight have died.
About 55 per cent live in the South Island, 30 per cent of those still in Dunedin, with about 20 per cent in the North Island, 15 per cent in Australia and about 10 per cent in the Northern Hemisphere.
Last year the HRC awarded the Dunedin Study almost $5 million dollars over five years for a life-course study on aging to inform early intervention strategies. That builds on more than 40 years of historic investment in the study by the HRC.
HRC-funded research has featured prominently in the PM Science Prizes. In 2014, the PM Science Prize was presented to another longtime HRC-funded study, the He Kainga Oranga/Housing and Health Research Programme, led by Professor Philippa Howden-Chapman. This recognised their work into nationwide housing deficiencies, especially affecting children, the elderly and those with chronic health problems. And in 2015, the top prize went to the Bone and Joint Research Group at the University of Auckland led by Professors Mark Bolland and Andrew Grey and Distinguished Professor Ian Reid, for their HRC-supported research.
For more information, visit the Prime Minister's Science Prizes website.
7 March 2017
The Health and Disability Commissioner is undertaking a public consultation about health and disability research involving adult participants who are unable to provide informed consent to participate in the research.
The effect of Right 7(4) of the Code of Health and Disability Service Consumers’ Rights (the Code) is that research with participants who cannot give informed consent cannot proceed unless the research is in the best interests of the participants. Recently, it has been argued that New Zealand’s laws regarding non-consensual research are too restrictive, and prohibit studies that could lead to significant improvements in health and disability services.
To help the Commissioner determine whether there is a need to change the Code, he has decided to undertake a consultation, during which members of the public will be invited to comment. This consultation will focus on two fundamental questions: are New Zealand’s current laws regarding non-consensual research appropriate and, if not, how should they be amended?
With the assistance of an expert advisory group, HDC has drafted a consultation document. The consultation document and submission form can be found at www.hdc.org.nz. The consultation document and submission form are also available in easy read format on HDC’s website.
The consultation started on 24 February 2017 and submissions will close on 30 April 2017.
The Commissioner is seeking views from all interested people, including consumers, persons interested in the welfare of people unable to consent for themselves (such as family/whānau), providers, and researchers. At the conclusion of the consultation he will review all of the submissions received and will then decide whether to recommend any changes to the current law.
2 March 2017
Researchers from Auckland and Otago Universities are the first recipients of new grants from PHARMAC and the Health Research Council of New Zealand (HRC).
Professor Keith Petrie at the University of Auckland, and Dr Lianne Parkin of the University of Otago, will receive grants worth more than $210,000 each for their research.
Generic medicines are equivalent to brand name medicines, providing the same quality and performance but usually at a lower cost. Professor Petrie’s study will look at how people’s views on generic medicines can affect their acceptance of these medicines.
Metformin is the first-line treatment for type 2 diabetes, however overseas research shows that many patients don’t use it as prescribed. Dr Parkin will explore how to improve the way New Zealanders with type 2 diabetes use metformin.
PHARMAC Chief Executive Steffan Crausaz and HRC Chief Executive Professor Kath McPherson announced the first recipients of the joint fund today.
Steffan Crausaz says the two studies will provide valuable insights into how New Zealanders can get the best out of medicines.
“Our objective in setting up the fund with the HRC was to improve our knowledge of medicines use in New Zealand, so that we can take steps to improve people’s use of medicines,” he says.
“Generic medicines are widely used in New Zealand, and research will look at what else can be done to help people adapt to changes in their medicine.
“Metformin is an important medicine for people with type 2 diabetes, so Dr Parkin’s research will give us a better idea as to why people might not continue taking the medicine they need to keep them well.”
Dr McPherson says the collaboration with PHARMAC is providing a further opportunity to grow innovative research into pharmaceuticals in New Zealand.
“We’re delighted to be involved in this research initiative with PHARMAC. This is a great example of government health organisations collaborating to benefit patients and strengthen the use of research evidence to improve our health system overall.
“I’m confident that the studies funded through this partnership initiative will be of a high quality and add to our knowledge of how New Zealanders use medicines.”
Details of grant recipients and studies
Professor Keith Petrie, University of Auckland
Improving acceptance of generic medicines
$213,750, 12 months
The focus of this proposal is on how to improve the acceptance of generic medicines. While positive perceptions of generic medicines are critical for acceptance, very little research has been done on how to effectively change attitudes towards generic medicines or to look at how the presentation of generic medicines can be improved. We propose two studies to look at the issue of improving acceptability and response to generic medicine. The first study evaluates whether highlighting the mechanism of action in branded and generic medicines medications being identical is an effective way of improving perceptions and response to generics. The second study examines whether generic medication can be branded more effectively and investigates whether improving generic packaging can improve the effectiveness and reduce the side effects of generic medication. The results of the proposed research may provide practical strategies that can be used to improve acceptance of generic medicines.
Dr Lianne Parkin, University of Otago
Improving metformin adherence and persistence in people with type 2 diabetes
$213, 229, 24 months
Type 2 diabetes mellitus (T2DM) imposes a substantial burden on New Zealanders, particularly Māori and Pacific peoples. Metformin is the first-line medication for the treatment of T2DM, but overseas research has found that many patients have suboptimal metformin adherence and persistence. Persistence refers to whether a person stays on a therapy, while adherence refers to whether a person takes a medication according to the prescribed schedule. Suboptimal metformin adherence and persistence are important because they are associated with a higher risk of diabetes complications.
We will use routinely collected health data to (a) describe the patterns of metformin adherence and persistence in New Zealanders with T2DM, and (b) investigate the predictors and consequences of suboptimal adherence and persistence. We will also interview people with T2DM to get their views on what helps, and hinders, good metformin adherence and persistence. The findings will contribute to improved outcomes for people prescribed metformin.